Title: Bored No More
Summary: At the risk of sounding like Sherlock, John was bored. The one night he's asked to take the nightshift at the A&E, is the one night when absolutely nothing happens. Finally a patient is brought in and it is the last person John ever wanted to see in his Emergency Room. This is a story of John's medical brilliance, because we don't see enough of it in the show.
Disclaimer: I own nothing but my ideas for the plot, as well as any and all errors in spelling and grammar. I do not own Sherlock Sir Arthur Conan Doyle, Steven Moffat and Mark Gatiss do. Any recognizable lines, characters or places in this work are inspired by the writings of Sir Arthur Conan Doyle, Steven Moffat and Mark Gatiss.
Warnings: Descriptions of injuries and medical procedures. Also I am not a medical professional; all medical information was found through research and may not be entirely accurate, though I did try my best. Not Betaed but edited 1/8/14
Rating: T for medical procedures, injuries, language and my own paranoia
*Arterial Blood Gas measures the amount of oxygen and carbon dioxide in the blood
Bored No More
At the risk of sounding like Sherlock, he was bored. Bored, bored, bored! John sighed feeling a sudden wash of empathy for the enigmatic detective; if this was how Sherlock felt all the time, he might cut the Detective some slack the next time he started shooting the walls or blowing things up. John sighed again running a hand through his short blond locks, before getting up and stretching his stiff muscles, his spine popping in relief.
Argggh how long had he been sitting in this seat? Oh right, all night, because the one night that he's asked to take the nightshift at the A&E, the good citizens of London decide to become the healthiest, safest people on the planet. Not that he wished anyone ill mind you, but he missed the thrill of diagnosing, treating and ultimately saving a life under pressure.
'God I really am turning into Sherlock.' thought John with a shake of his head.
"Quite night, eh Doc?" commented Berta the head nurse on shift.
"So far," John agreed. "I suppose we should be thankful that the people of London are safe and sound." John said with a teasing smile.
"There's that I suppose but it makes for a long, dull night." the nurse replied.
"Don't I know it." John murmured as he headed for the electric kettle at the nurses' station to fix himself a cuppa.
Thirty minutes and two cups of tea later, John was begging for someone, anyone to come through the emergency doors. At the moment he would be happy to treat an ingrown toenail.
"Dr. Watson!"
John startled sloshing his tea down his right sleeve.
"Dr. Watson, we have an incoming trauma patient with penetrating chest wound, ETA two minutes."
John hastily put down his tea and dried his sleeve.
"Alright get the room prepped, have radiology standing by we will need chest x-rays, have a ABG* test prepped, get a chest tube kit ready, and have several blood types on hand and ready to go. Oh and grab a couple bags of saline as well." John ordered calmly and decisively. He always liked to have as much as possible prepped before the patient arrived, that way less time was wasted in gathering supplies and more time was spent treating the patient.
The two minutes flew by, and before he knew it the patient was being ushered through the emergency doors.
"What's the situation?" John demanded the moment the EMS workers cleared the doors.
"We have a thirty to thirty five year old Caucasian male with a penetrating chest wound, and suspected lung trauma. The patient is shocky, BP is seventy five over fifty, breathing is shallow, and the patient was complaining of difficult and painful breathing before loosing consciousness." Rattled off one of the men ushering the gurney inside.
"Alright get him in to trauma one, Berta start him on a Saline drip, and check his blood type." John ordered as he finished pulling on a pair of sterile medical gloves.
As John followed the gurney into the trauma room, he got his first good look at his patient and he stopped dead in his tracks; his muscle locking in place and refusing to move.
It couldn't be, there was no way. John closed his eyes briefly, before opening them, hoping that the image in front of him would have changed. It didn't.
"Sherlock." John gasped out breathily.
His mind was spinning, his ears were ringing, and John could feel himself start to hyperventilate; his breathing coming in painful and frantic gasps. In his mind the image of Sherlock laying pale on the gurney superimposed with one of him lying bloody on the sidewalk outside this vary hospital. This could not be happening, he couldn't do this, not again.
"Doctor, do you know the patient?" Asked one of the nurses.
"He's my flat mate, Sherlock Holmes." croaked John.
The nurses looked John up and down assessing him. "I think we should call down one of the other Doctors in the Hospital to take this patient."
"NO!" John shouted instantly. The thought of some other Doctor handling Sherlock's case made him feel ill and a bit possessive.
Taking a deep breath drawing on his combat calm, in order to pull himself together. "No, I can handle it and we don't have time to wait for a replacement to get their Arse down here."
"Doctor Watson I really think that it would be better to-"
"No Berta, I can handle it! It is no different than being in Afghanistan and having to treat the men in my unit! Now we have a patient to examine." John said firmly, squaring his shoulders and striding to Sherlock's side.
Once there, he immediately began his own brand of deductions. Glancing at the heart monitor, he noted that Sherlock's blood pressure was low and dropping and judging by the amount of blood seeping through the bandage wrapped around his ribs he was going into hypovolemic shock. Though the saline was helping Sherlock desperately needed a blood transfusion.
"Berta what's his blood type?"
"Its AB Negative we only have one bag of that exact type, but we have several bags of negative A, B, and O."
John snorted trust Sherlock to have the rarest blood type in the world.
"Start him on the bag of AB negative, and keep the others on hand, he's hypovolemic." John said as he continued his diagnosis.
Cutting through the bandages wrapped around the man's ribs, John got his first glimpse of Sherlock's wound. It was obviously a knife wound located on the right side of his chest in-between the sixth and seventh rib; it was high enough that it missed the liver, but John feared it may have punctured the lower lobe of the lung.
John was also concerned that his friend may be suffering from a Tension Pneumothorax, and if that condition was left untreated for too long, the air pressure collecting in Sherlock's chest would cause his lung to collapse and his heart to fail. Quickly glancing at the monitors showing Sherlock's vitals, John was glad to see that his blood pressure had improved and he pulse was stronger and steady. But he was still not satisfied.
"I need a ABG and a chest x-ray STAT." John ordered one of the nurses.
As the chest x-rays were being done John looked over the results of the ABG noting that Sherlock's blood oxygen levels were low, and his carbon dioxide higher than he liked. Taking all of this into account John was positive that Sherlock had a collapsed or nearly collapsed lung.
"The chest X-rays are done Doctor."
"Thanks." John muttered as he hastily made his way to the digital monitor.
Looking at the skeletal chest of his flat mate, John could easily see that the lung was partially deflated confirming his diagnoses of a Tension Pneumothorax. Fortunately, by some miracle, the knife did not seem to have punctured the lung, though it did nick the bottom part of the sixth rib. There was also no sign of severe internal bleeding, something John was more than thankful for.
Going back over to Sherlock, John grabbed the chest tube kit; he needed to aspirate the air in the detective's chest as soon as possible. Before he did that however, he needed to suture the knife wound, or the chest tube would be null and void.
After numbing the area, John began carefully sewing the gaping hole shut. It took a bit for John to get the layers of muscle and skin sutured to his satisfaction, and he monitored his friend breathing closely. Thankfully there were no complications and he soon had the wound closed and bandaged.
Finally John addressed the Tension Pneumothorax. Just as he began cleaning the area in which he was going to insert the chest tube, John was surprised to find that Sherlock was coming round; and unfortunately the Consulting Detective was panicking.
"Sherlock, can you hear me? It's John, you're in the Hospital and I need you to lay still, I have to get this chest tube in, can you do that for me?" John asked his tone low and soothing.
"John- hurts." Sherlock gasped, turning his head slightly to look John's direction.
John felt as if his heart was being ripped violently out of his chest at his friend's weak pain-filled admission. "I know Lock, I know. I need to put in that chest tube now okay? You have a-"
"Ten-sion Pneu-mo-tho-rax" the raven haired man wheezed.
"Yes exactly, now stop talking so that I can fix it." John ordered, amazed that even in his current condition, Sherlock could still pull off amazing feats of deduction.
"Okay Sherlock this is going to pinch and sting." John warned before injecting local anesthetic into several spots around area in which the chest tube would be placed.
Sherlock let out several hissed breaths but otherwise showed no sign that he was in pain. John hoped that meant that the IV pain meds were working.
"How are you feeling Sherlock?" he questioned as they waited for the numbing agent to take full effect.
The look Sherlock gave him plainly said that thought John was an idiot for asking, and that made John smile tightly in relief.
"Right, stupid question I know. Okay Sherlock I am going to make the incision for the chest tube now. You shouldn't feel anything, but let me know if you do and don't move." John said as he picked up his scalpel.
He quickly made a small one inch incision in between the fifth and sixth rib just above the initial injury, swiftly cutting through the layers of skin and muscle. As soon as he finished the incision, John used his finger to check the depth and angle before quickly grabbing the tube.
"Sherlock you still with me?"
The detective groaned.
"Good, okay I'm getting ready to insert the chest tube; you will feel some pressure and strange sensations and when I tell you to, you need to take as deep a breath as you can. Just after that you should be able to breathe easier." John said as he positioned the tube just inside the incision.
"Alright Sherlock, deep breath." said John firmly, and has his friend struggled to take a deep breath, John pushed the tube the rest of the way in.
The effect was immediate; Sherlock's breathing eased and evened, his whole body loosing the tension it held. John taped the tube into position before calling over the radiology technician.
"I need another chest x-ray just to be sure the tube is in a good position."
"Righty-O" the young tech replied before getting the machine set up.
John moved back to Sherlock who looked exhausted. "Sherlock we need to get one more x-ray and then we will get you settled into a room for the night alright."
The man nodded weakly, giving no complaint; that alone told John just how bad the detective was feeling.
The x-ray was quick and confirmed that the tube was in the ideal position. John then quickly stitched the tube in place, before removing the tape.
"Alright let's get him into a room, one of the private suites on the upper floor." John said wearily to the nurses; he was starting to feel exhausted as he came off of his adrenalin high. It was hard to imagine that all of that chaos happened in less than half an hour.
"But sir, those rooms are for high-
"I know who the rooms are for, but if his brother hasn't demanded it yet, he will and I would rather we don't have to move him again. If I am wrong I will take responsibility." John said decisively.
Turning back to the dozing detective, John couldn't resist gently brushing a few strands of curly black hair out of Sherlock's eyes.
"Sherlock?"
"Hmm."
"These nurses are going to move you into a room, I expect you to cooperate for them alright. I have a few things to finish up down here and then I will be up to check on you oaky." John said his voice low and tranquil.
Sherlock made some kind of noncommittal noise, which John took as meaning he would behave if they weren't a bunch of simpletons.
"How long?" the man questioned.
"You're going to be here a couple days, Lock. We have to make sure that your lung won't collapse again, and we will keep you on oxygen at least over night. And when you go home you will have to take it easy for a week or two that means no running across London and tackling weapon wielding bad guys."
Sherlock harrumphed, pouting petulantly.
"You need time to heal Sherlock." John said exasperatedly.
"But John, healing is boring." the detective whined.
John shook his head; that was the detective he knew and loved.
"I'll see you in a bit Sherlock."
John strode out of the room knowing that Sherlock would be fine for a bit and right now, he wanted to know how in the Bloody Hell Sherlock managed to get stabbed in the first place; and he knew exactly how to find out. As he walked determinedly into the waiting room John saw both, Lestrade and Mycroft waiting and hoped for their sakes had an extremely good excuse, because if not, they were going to answer to him.
A/N: Hi everyone! This is my first Sherlock fanfiction so hopefully it wasn't too bad! : ) I have always felt that John's medical abilities are not played up enough in the show, and that sparked this one shot.
Thanks for reading,
Godiva9